Individual provider Active NPI

Martia Alison Myers de Pina, LMFT

  • Marriage & Family Therapist
  • Chantilly, VA
National Provider Identifier
1679954366
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717001536 Issued in VA
Practice address
14150 Parkeast Cir
Chantilly, VA 20151-2295
Phone
(703) 968-4000
Fax
(703) 449-6110
NPI assigned
Jun 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717001536 VA Primary

Addresses

Primary practice location

14150 Parkeast Cir
Chantilly, VA 20151-2295

Mailing address

14150 Parkeast Cir
Chantilly, VA 20151-2295
Phone (703) 968-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215000748 DC Practitioner - Marriage and Family Therapist 2365891306 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0717001536VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Jan 1, 2024 Accepting new patients

Locations

14150 Parkeast Cir
Ste 200
Fairfax, VA 20151
Phone (703) 449-6114

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1679954366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 PARKEAST CIR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512295",
            "telephone_number": "703-968-4000",
            "fax_number": "703-449-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 PARKEAST CIR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512295",
            "telephone_number": "703-968-4000",
            "fax_number": "703-449-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS DE PINA",
        "first_name": "MARTIA",
        "middle_name": "ALISON",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.